The effects of licit and illicit recreational drugs on prospective memory: a meta-analytic review

Abstract

Rationale: There are no recent reports summarising the magnitude of prospective memory (PM) impairments in recreational drug users.

Objective: We performed a meta-analysis of studies (with a parallel group design) examining PM performance in users of common recreational drugs (including alcohol and tobacco) who were not intoxicated during testing. Studies were also evaluated for the presence of methodological bias.

Methods: Twenty-seven studies were included in the meta-analysis following literature searches of MEDLINE, EMBASE and PsycINFO. Effect sizes (standardised mean difference; SMD) were calculated separately for the effects of alcohol, cannabis, ecstasy, methamphetamine and tobacco use. The influences of drug use and study characteristics on effect sizes were explored using meta-regressions. Sources of study bias were also assessed.

Results: Heavy drinkers and regular drug users tended to perform worse than controls on event and time-based PM tasks. Effect sizes (standardised mean differences; SMDs) for event-based PM impairment across the different drug-using groups/heavy drinkers ranged between - 1.10 and - 0.49, with no 95% CI crossing 0.00. SMDs for time-based PM ranged between - 0.98 and - 0.70. Except for the CIs associated with the ES for smokers' time-based PM performance, no CIs crossed 0.00.

Conclusions: Although all drug-using groups showed moderate-large impairments in event and time-based PM, effect sizes had low precision and moderate-high levels of heterogeneity. In addition, several methodological and reporting issues were identified in the majority of studies. As such, considerable uncertainty remains regarding the role of confounds and the magnitude of PM impairments in non-intoxicated recreational drug users.

Keywords: Alcohol; Cannabis; Ecstasy; Methadone; Methamphetamine; Opiate; Prospective memory; Tobacco.

Fig. 1

Primsa flowchart

Fig. 2

Risk of bias summary: Prevalence of bias for each domain presented as percentage of studies with high, low or unclear risk of bias

Fig. 3

Forest plot of comparisons for event-based PM tasks across drug conditions. The width of each node is identical to the width of the confidence interval. The height of each raindrop is scaled with respect to its relative meta-analytic weight considering all studies within the subgroup

Fig. 4

Forest plot of comparisons for time-based PM tasks across drug conditions. The width of each node is identical to the width of the confidence interval. The height of each raindrop is scaled with respect to its relative meta-analytic weight considering all studies within the subgroup